Sunday, May 08, 2005

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Keith said "I believe that one's living will should be the final word, as long as it is in accordance with applicable law," which goes right to the heart of the matter. Before even worrying about a living will, the conscious, coherent, and rational patient is still severely constrained in their choices by those 'applicable laws'. To what end?

dezerai said "I also believe that the current medical establishment is goal driven to obtaining the max dollar for almost nothing." This seems logical and could certainly be supported by my own anecdotes. I tend to think it is accurate though very unpleasant to consider. What could the medical community do to refute this, or change it?

81 Comments:

You put forth this question: What could the medical community do to refute this, or change it?

To answer this we must ask ourselves this: How can we live in a modern age with such advanced technologies, and yet as one of the richest nations not afford our own peoples healthcare. The answer is clear, our government is not for the people it is for the corporation. Maybe we should have health and education for the people and let the corporations fight their own wars.

Before even worrying about a living will, the conscious, coherent, and rational patient is still severely constrained in their choices by those 'applicable laws'. To what end?

Whatever end community standards deem acceptable. I think as a GenXer that community standards will move enough that I will see physician-assisted suicide legalized nationwide in my lifetime. (I won't necessarily avail myself of that option, of course.) The good news is that in the meantime there are options. If having the option of having a doctor end your life is important, move to Oregon. Or work to change the laws in your own state. Good luck.

dezerai said "I also believe that the current medical establishment is goal driven to obtaining the max dollar for almost nothing." What could the medical community do to refute this, or change it?

A major contributing factor to this is that most health care is transactional. We pay per service regardless of the result. As a result, health care providers do not have an incentive for cost-effective treatment but for cost-ineffective treatment! If I have an illness and it could probably be fixed with a month of generic drugs, or it could be fixed with an expensive operation, the health care company would rather I opt for the operation because it is more profitable. This is an oversimplification, of course, but it does go to the root of the problem, the way we pay for health care.

What if the health care company was paid the same amount based on the illness remedied rather than the way in which it is remedied? Then they would have an incentive for more cost-effective treatment. It would also be critical that the treatment be successful because pay would be contingent upon recovery.

Any major change in the health care payment system must take insurers into account, and would be well served by beginning with them. Such a large percentage of health care payments pass through insurers that probably only they would have the ability to effect a fundamental change like this. As I understand, there are currently discussions underway about shifting Medicare and Medicaid in this direction. We just have to be careful that cost-effective doesn't turn into cost-control; health care must be effective also!

I'm sorry for being intrusive in to your blog. But I am Melissa and I am a mother of two that is just trying to get out of an incredible financial debt. See my hubby is away in Iraq trying to protect this great country that we live in, and I am at home with our two kids telling bill collectors please be patiant. When my husband returns from war we will beable to catch up on our payments. We have already had are 2001 Ford repossessed from the bank, and are now down to a 83 buick that is rusted from front to back and the heater don't work, and tire tax is due in November.

I'm not asking for your pitty because we got our ownselfs into this mess but we would love you and thank you in our prayers if you would just keep this link on your blog for others to view.

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I was just browsing various blogs as I was doing a search on the word poster, and I just wanted to say that I really like what you've done with your blog, even though it wasn't particularly related to what I searched for. I appreciate your postings, and your blog is a good example of how a blog should be done. I've only just recently started a Posters website - feel free to visit it when you get a chance if you wish. Much success, antonio.

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